Emerging Treatments in Psoriatic Arthritis

Dr. Ogdie

CHICAGO—As part of a scientific session of ACR Convergence 2025 on Sunday, Oct. 26, Alexis Ogdie, MD, associate professor of medicine and director of the University of Pennsylvania Psoriatic Arthritis and Spondyloarthritis Program, Philadelphia, discussed new and forthcoming treatments for psoriatic arthritis. “We have lots of therapies and lots of new therapy options,” said Dr. Ogdie. “Part of what we need to do is figure out how to best use them.”

Treatment Landscape

Approach to treatment of psoriatic arthritis has evolved significantly over the past 15 years. Disease heterogeneity, difficult-to-treat patients and the introduction of new agents have all made it more challenging to create clinical guidelines.^1-3

The current guideline from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), which Dr. Ogdie recommended as a helpful resource, uses a symptom domain approach (e.g., primary axial disease vs. enthesitis vs. peripheral arthritis) paired with comorbidity considerations to aid in treatment decisions.²

Based on these considerations, clinicians can now work with patients to choose from several different classes of treatment, with a recent addition and some others that may soon become options (click to see Table below).

IL-17 Inhibitors

For almost a decade, clinicians have been able to prescribe therapies based on interleukin (IL) 17 inhibition, with the approval of the U.S. Food & Drug Administration (FDA) of secukinumab for psoriatic arthritis followed by the approval of ixekizumab. Both these agents inhibit a specific version of cytokine IL-17, IL-17A. A similar therapy, brodalumab, works slightly differently as an IL-17 receptor blocker, but it is currently approved only for psoriasis and not for psoriatic arthritis.

In September 2024, the FDA approved a new member of this class for psoriatic arthritis, bimekizumab, a humanized monoclonal IgG1 antibody that binds to and inhibits both IL-17A and IL-17F. IL-17A and IL-17F share some overlapping inflammatory properties, but IL-17F is more elevated in psoriatic issues. Although comparative studies in psoriatic arthritis are not available, bimekizumab may provide more effective skin clearance compared with earlier IL-17 agents.⁴

Dr. Ogdie shared results from two phase 3 trials that demonstrated bimekizumab’s efficacy and safety in both treatment-naïve patients and in those poorly responding to anti-tumor necrosis factor (TNF) agents. Dr. Ogdie noted that psoriatic arthritis treatment response was comparable in bimekizumab and adalimumab. Skin response scores were noticeably better in the bimekizumab group, consistent with earlier work demonstrating the superiority of this class of agents in skin symptoms over anti-TNF therapies.^5,6